首次发布：2020年5月30日
关键词：外伤，⽛撕脱伤，⽛齿折断，预防，⽛脱位性损伤
Keywords：Trauma, avulsion, tooth fracture, prevention, luxation
简略标题：IADT⽛外伤指南：总论
Short title：IADT guidelines for management of traumatic dental injuries: General Introduction
DOI：/10.1111/edt.12574
译者：张黎丽、丁谦⽂、张昕、龚怡
摘要 (Abstract)
⽛外伤(TDIs)多好发于⼉童和青少年，在⽼年⼈中的发病率明显低于年轻体。乳⽛外伤最
常见的类型是⽛脱位性损伤，⽽恒⽛外伤则多见于⽛冠折。 正确的诊断、及时的和随访观察对⽛外伤的良好预后⾄关重要。国际⽛外伤协会(IADT)在全⾯回顾1996-2019年 EMBASE, MEDLINE, PUBMED, Scopus和Cochrane 数据库的⼜腔学科⽂献的基础之上，结合2000⾄2019年《⽛外伤学》杂 志的⽂献，制定了最新的⽛外伤指南。制定指南的⽬的是为⽛外伤的患者能够得到即刻或紧急 的救治提供相关的信息，以便在后续中能够得到经验丰富的⽛外伤专家和⼜腔全科医⽣的进⼀步。
Traumatic dental injuries (TDIs) occur most frequently in children and young adults. Older adults also suffer TDIs but at significantly lower rates than individuals in the younger cohorts. Luxation injuries are the most common TDIs in the primary dentition, whereas crown fractures are more commonly reported for the permanent teeth. Proper diagnosis, treatment planning and follow up are very important to assure a favorable outcome. These updates of the International Association of Dental Traumatology's (IADT) Guidelines include a comprehensive review of the current dental literature using EMBASE, MEDLINE, PUBMED, Scopus, and Cochrane Databases for Systematic Reviews searches from 1996 to 2019 and a search of the journal Dental Traumatology fro
m 2000 to 2019. The goal of these guidelines is to provide information for the immediate or urgent care of TDIs. It is understood that some follow‐up treatment may require secondary and tertiary interventions involving dental and medical specialists with experience in dental trauma.
与以往制定⽛外伤指南的⽅法相同，此次参与制定⽛外伤指南的专家来⾃于⼜腔专业的不同 学科、以及社区的⼜腔全科医⽣，他们具有科学研究的基础和丰富的临床经验。此次修订的⽛外伤klein 指南是基于现有的⽂献和专家意见，在某些已公布的⽂献数据有争议的情况下，牙外伤指南的提出 得到了专家们的⼀致认可，并由IADT董事会成员审查和批准通过。指南的应⽤要根据病⼈的具体情况⽽定，临床医⽣应对病情进⾏仔细的判断和评估，根据病⼈的依从性、经济状况、在各种⽅案中进⾏优化选择，医⽣应明确判断病⼈的⽛外伤类型和损伤程度、以及远期的预后效果。 虽然 IADT不能保证医⽣遵循⽛外伤指南就⼀定会使病⼈得到良好的预后效果， 但是IADT可以相信，医⽣在临床中应⽤指南可以极⼤提⾼⽛外伤患者良好预后的概率。
As with previous guidelines, the current working group included experienced investigators
and clinicians from various dental specialties and general practice. The current revision represents the best evidence based on the available literature and expert opinions. In cases where the published data were not conclusive, recommendations were based on the consensus opinions of the working group. They were then reviewed and approved by the members of the IADT Board of Directors. It is understood that guidelines are to be applied using careful evaluation of the specific clinical circumstances, the clinician's judgment, and the patient's characteristics, including the probability of compliance, finances and a clear understanding of the immediate and long‐term outcomes of the various treatment options vs non‐treatment. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines. However, the IADT believes that their application can maximize the probability of favorable outcomes.
微核1 前言 INTRODUCTION
⽛外伤(TDIs) 多发⽣于⼉童和青少年，占所有外伤的英国海外志愿服务社5%。25%的学龄⼉童都曾有过⽛外伤的 经历，33%的成年⼈也曾有过恒⽛外伤的经历，其中⼤多数⽛外伤发⽣在19岁之前。研
究显⽰：乳⽛外伤最常见的类型是半脱位，⽽恒⽛外伤则多见于冠折。 我们认为：医⽣对⽛外伤的正确诊断和 选择适宜的计划、以及⽇后的随访观察，对⽛外伤患者的良好预后是⼗分重要的。
Traumatic dental injuries (TDIs) occur frequently in children and young adults, comprising 5% of all injuries. Twenty‐five percent of all school children experience dental trauma and 33% of adults have experienced trauma to the permanent dentition, with the majority of the injuries occurring before age 19. Luxation injuries are the most common TDIs in the primary dentition, whereas crown fractures are more commonly reported for the permanent teeth. Proper diagnosis, treatment planning and follow up are important to assure a favorable outcome.
目前国际⽛外伤协会(IADT)在全⾯回顾1996-2019年 EMBASE、MEDLINE、PUBMED、 Scopes searches 数据库的⼜腔学科⽂献的基础之上，结合2000⾄2019年《⽛外伤学》杂志的⽂献，制 定了最新的⽛外伤指南。
These updates of the International Association of Dental Traumatology's (IADT) Guideline
蛋白修饰s include a review of the current dental literature using EMBASE, MEDLINE, PUBMED, and Scopus searches from 1996 to 2019 and a search of the journal Dental Traumatology from 2000 to 2019.
⽛外伤指南的⽬的是为⾸诊医⽣提供即刻或紧急救治⽛外伤患者的⽅法，以便在后续治 疗中得到经验丰富的⽛外伤专家和⼜腔全科医⽣的进⼀步。
The goal of these guidelines is to provide information for the immediate and urgent care of TDIs. It is understood that some of the subsequent treatment may require secondary and tertiary interventions involving specialists with experience in dental trauma.
IADT在2001年发布了第⼀版⽛外伤指南，并于2007年进⾏了指南的更新，在2012年的《⽛离开中国制造的一年 外伤学》杂志上又公布了指南的再⼀次修订更新。根据以前制定指南的要求，此次参与指南制定的 专家团队包括了经验丰富的研究⼈员和从事⼜腔专业不同学科的专家、以及全科医⽣。此次修订的⽛外伤指南是基于现有的⽂献和专家意见，在某些公布的数据没有统⼀结论的情况下，⽛外伤38ttt 指南的提出得到了专家们的⼀致认可，并由IADT董事会成员审查和批准通过。
The IADT published its first set of guidelines in 2001 and updated them in 2007. A further update was published in Dental Traumatology in 2012. As with previous guidelines, the current working group included experienced investigators and clinicians from various dental specialties and general practice. The current revision represents the best evidence based on the available literature and expert professional judgment. In cases where the data were not conclusive, recommendations were based on the consensus opinion of the working group, then reviewed and approved by the members of the IADT Board of Directors.
指南的应⽤要根据病⼈的具体情况⽽定，临床医⽣应对病情仔细的判断和评估，根据病⼈的依从性、经济状况、以及各种⽅案的选择，医⽣应明确判断病⼈的⽛外伤类型和损伤程度、以及远期的预后效果。 虽然IADT不能保证医⽣遵循指南操作就⼀定会使病⼈获得良好的预后效果， 但是IADT可以相信，医⽣在临床中应⽤⽛外伤指南，可以⼤⼤增加⽛外伤患者预后良好的概率。
It is understood that guidelines are to be applied with evaluation of the specific clinical cir
cumstances, clinicians' judgment and patients’characteristics, including but not limited to the probability of compliance, finances and an understanding of the immediate and long‐term outcomes of treatment options vs non‐treatment. The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines, but the IADT believes that their application can maximize the chances of a favorable outcome.
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